Purpose: Due to the cross-sectional shape of interdental spaces, it was assumed that interdental brushes having heads with a triangular cross section have an improved cleaning efficacy compared to conventional round brushes. The aim of this study was to evaluate in vitro the cleaning efficacy of triangular (TIB) compared to round interdental brushes (RIB).Materials and Methods: Extracted natural human teeth were fixed in a socket and matched to pairs in a reversible and reproducible manner, simulating two types of small interdental spaces. The proximal tooth surfaces were covered with a dye indicator to simulate plaque. After registering the baseline situation with a digital camera and a highly reproducible geometrical setup the teeth were relocated in their contact position. The interdental spaces were cleaned in a standardized manner followed by digital imaging of the proximal tooth surfaces as described above. The cleaning efficacy was quantified and related to the total proximal tooth surface by digital image subtraction. Four RIB and four prototypes of TIB, which were appropriate for application in small interdental spaces, were tested (n = 12).Results: In isocele, equilateral and both types of interdental spaces the round interdental brushes cleaned 37± 3%, 33± 3% and 35± 2% (Curaden), 50± 6%, 45± 6% and 48± 7% (Tepe), 50± 3%, 40± 2% and 45± 3% (Oral B) and 41± 6%, 33± 4% and 37± 3% (Butler), respectively. The triangular brushes cleaned 64± 7%, 49± 4% and 56± 4% (GABA #4), 67± 4%, 54± 5% and 60± 5% (GABA #5), 69± 6%, 54± 5% and 61± 5% (GABA #6), and 80± 6%, 59± 4 and 69± 3% (GABA #7), respectively. The differences between all groups were statistically significant (p

Introduction: The cleaning efficacy of different toothbrushes is often tested in a plaque regrowth crossover design, i.e. participants have to abstain from oral hygiene, repeatedly. This might influence the amount of plaque accumulation. As the baseline plaque is the most important confounder for the amount of plaque reduction those changes would significantly influence the outcome of the study.Aim of the study: The aim of the study was to investigate whether or not a crossover design would influence the 24-hours plaque regrowth.Materials and Methods: In two separate toothbrush studies with a crossover design, 158 partici-pants volunteered to abstain twice (T1 and T2) for 24 hours from all oral hygiene pro-cedures prior to the test. The time between the two arms of each study was 12 days. Plaque accumulation was measured by one calibrated examiner using the Turesky modification of the Quigley & Hein Index.Results: The overall 24-hours plaque regrowth resulted in scores of 2.10± 0.60 (T1), and 1.67± 0.56 (T2; p

The identification of burned bodies correlates with an adequate quality and quantity of traces (1,2). By car-accident two adults burned and died. A third could be rescued by fire-fighters and was transferred to the hospital. The identification of the dead bodies was made exclusively by odontological comparison of ante-mortem plaster casts, x-rays and a-m/p-m records after oral section and maceration of the removed jaws.

A case of Necrotizing Ulcerative Periodontitis (NUP), rendering the most severe inflammatory periodontal disorder caused by plaque bacteria is shown. Clinically, the gingiva showed distinct signs of ulceration and radiography revealed horizontal bone loss. Indirect immunofluorescence, carried out on frozen sections of tissue specimens obtained from the NUP lesion exhibited clear expression of atypical Keratin K19 particularly in basal cells, when compared to non-inflamed gingiva.Moreover, NUP tissue showed extensive intraepithelial abundance for the basement membrane component laminin-1/-10 and the extracellular matrix molecule tenascin. Strong expression of integrin subunit αv and matrix metalloproteinase/MMP-13 in conjunction with IL-1ß further discriminated NUP gingival epithelium from normal tissue. The results suggest that NUP is associated with changes in the expression and topography of the analyzed molecules in the gingival epithelium which in turn may reflect the fast progression of the disease.

Objective: Previous studies have shown a correlation between the clinical performance of adhesive systems and the use of flowable composites. The aim of the present study was to evaluate the difference of micro tensile bond strength (µ-TBS) of three different composite/ adhesive combinations depending on the additional use of the corresponding flowable composite.Methods: In this study twenty-four freshly extracted third molars were included. All teeth were prepared in a special manner allowing the simulation of dentin perfusion. The specimens were randomly assigned to six experimental groups of four samples each: group A: Excite/ Tetric Ceram; group Af: plus Tetric Flow; group B: Clearfil New Bond/ Tetric Ceram; group Bf: plus Tetric Flow; group C: AdheSE/ Tetric Flow; group Cf: plus Tetric Ceram. All materials were applied in a standardized class II cavity. After 24 h in water, the specimens were cut perpendicularly with a low-speed diamond saw to obtain sticks with a surface area of 1mm2 (n=15). The µ-TBS was measured using a Bencor device in an universal testing machine.Results: Following µ-TBS were evaluated (mean value and standard deviation printed in MPa): Group A: 18.27 (± 6.09), Af: 26.82 (± 6.68), B: 22.82 (± 5.82), Bf: 24.23 (± 7.95), C: 20.34 (± 6.89), Cf: 21.97 (± 6.55). Statistical analysis revealed significant differences between the six groups (p

Objectives: the aim of this pilot randomized split-mouth study was to evaluate and compare the clinical effects of two chlorhexidine-based gels delivered into periodontal pockets during initial periodontal therapy.Methods: Eight patients (four male and for female) suffering of chronic periodontitis and displaying each periodontal pockets deeper than 5 mm underwent a periodontal examination at baseline and after four weeks. This included the assessment of PI, BOP, PD, and CAL. PD and CAL were recorded at six sites per tooth. A total of 188 teeth were examined. The mean overall values of PD and CAL per quadrant were taken into account in this study. Each patient received SRP during initial therapy according to the one-stage Full Mouth Disinfection (Quirinen, 1995).In addition, each quadrant of the same arch was assigned to randomly receive a single subgingival application of either a novel chlorhexidine-based gel (Chlosite®, Ghimas s.p.a., Italy) or the chlorhexidine-gel PlakOut®, Santa Balanos, Greece). Subsequently, patients were advised to use 0,2% chlorhexidine mouthwashes (PlakOut®, Santa Balanos, Greece), twice a day, for the following four weeks, and OHI were reinforced. The Wilcoxon test was used to compare the differences between the baseline and four weeks after and for the differences between the groups.Results: Both therapies resulted in significant improvements in all clinical indices. At four weeks after application, in the Chlosite group the mean PD changed from 3.97±0.91 to 2.81±0.70 (p=0.012) and the CAL changed from 4.14±1.09 to 3.37±1.25 (p=0.03), while in the PlakOut group the PD changed from 3.88±0.77 to 2.78±0.53 (p=0.01) and the CAL changed from 4.02±0.96 to 3.42±1.01 (p=0.09). The Chlosite group resulted in slightly higher CAL gains (mean D=1.62 mm) and PD reductions (mean D=0.18 mm) than the PlakOut group, but these differences were not statistically significant due to the low number of cases.Conclusions: Following both initial therapy approaches, there were clinical improvements at four weeks from baseline. Additional topical subgingival application of Chlosite is safe and provided more favorable CAL gain and PD reduction than PlakOut.

Schlagwörter: initial periodontal therapy, chlorhexidine

Konferenz/Veranstaltung:
9th International Symposium "The stomatological days in Banat"20-22 May 2003Timisoara, Romania

A polylactide-polyglycolide copolymer (Fisiograft®, Ghimas S.p.A., Italy) was recently used to treat closed bone defects and for sinus floor augmentations. The material is manufactured as gel, granules or sponge, displays a good handling during the surgery; degradation occurs through "bulk erosion" by hydrolysis.Objective of this clinical controlled study was to compare clinically the treatment of deep intrabony defects with the combination of flap surgery (FS)+ Fisiograft® to the FS alone.13 patients with chronic periodontitis, displaying a total of 24 deep intrabony defects, were randomly treated either with FS + Fisiograft® (test) or with FS(control). Soft tissue measurements were made at baseline and six months following the surgery. The Wilcoxon paired-samples test was used to statistically evaluate the changes from baseline to six months;the Mann-Whitney U independent-samples test was used for comparison between the groups.No differences in any of the investigated parameters were observed at baseline between groups. Healing occurred uneventful in all patients. At six months after therapy, the test group showed a reduction in mean probing depth (PD) from 7.92 ± 1.88 mm to 3.83 ± 1.27 (p=0.002) and a change in mean clinical attachment level (CAL) from 8.58 ± 1.78 mm to 5.50±1.78 (p=0.003). In the control group, the mean PD was reduced from 7.08 ± 1.08 mm to 4.42 ± 1.44 (p=0.002) and the mean CAL changed from 8.00 ± 1.28 mm to 7.00 ± 2.13 (ns). The test treatment resulted in statistically higher PD reductions (p=0.024) and CAL gains (p=0.02) than the control group. In both groups, a minute or no radiographic defect fill was observed at six months after treatment.At six months after the surgery both therapies resulted in PD reductions and CAL gains.Treatment with flap surgery + Fisiograft® resulted in significantly higher CAL gains and PD reductions than treatment with FS alone.

An oily Calcium Hydroxyde suspension (Osteoinductal®, Osteoinductal GmbH., München, Germany) was documented to induce bone regeneration in closed defects. Combined with a bone replacement material, the suspension produced statistically significant changes of the PD and CAL.The aim of this study is to evaluate the effect of Osteoinductal® alone in the treatment of deep intrabony defects, when compared to access flap (AF) surgery alone.30 patients with one intrabony defect each were randomly treated with either AF+Osteoinductal® (test) or AF alone (control). The parameters evaluated at baseline and six months after surgery were: PI, BOP, PD, GR, CAL. Postsurgical care - administration of antibiotica (Amoxicillin 3x500 mg/die one week, 0.2% Chlorhexidine rinses twice daily for two weeks. Statistical analysis - the Wilcoxon paired test for evaluation of the changes from baseline to six months, and the Mann-Whitney U independent test for comparisons between the groups.At six months, measurements revealed in the test group a reduction in mean PD from 8.60 ± 2.06 mm to 3.27 ± 1.39 (p

Aim of this pilot randomized split-mouth study was to evaluate and compare the clinical effects of two chlorhexidine-based gels delivered into periodontal pockets during initial periodontal therapy.Eight patients suffering of chronic periodontitis and displaying periodontal pockets deeper than 5 mm underwent examination at baseline and after four weeks. This included assessment of PI, BOP, PD, and CAL. PD and CAL were recorded at six sites/tooth.188 teeth were examined. Maximal values of PD and CAL per quadrant were taken into account. Each patient received SRP during initial therapy according to the one-stage full mouth disinfection (Quirinen, 1995). In addition, each quadrant of the same arch was assigned to randomly receive a single subgingival application of either a novel chlorhexidine-based gel (Chlosite®, Ghimas s.p.a., Italy) or the chlorhexidine-gel PlakOut®, Santa Balanos, Greece). Subsequently, patients were advised to use 0,2% chlorhexidine mouthwashes (PlakOut®, Santa Balanos, Greece), twice a day, for the following four weeks. The Wilcoxon test was used to compare the differences between baseline and four weeks after and for the differences between groups.Both therapies resulted in significant improvements in all clinical indices. At four weeks, in the Chlosite group the mean PD changed from 8.88±2.30 to 4.88±1.73 (p=0.012) and the CAL changed from 9.00±2.27 to 6.25±1.67 (p=0.027), while in the PlakOut group the PD changed from 8.88±1.64 to 6.50±2.33 (p=0.026) and the CAL changed from 8.88±1.64 to 7.38±3.96 (p=0.233). The Chlosite group resulted in higher CAL gains (mean Δ=1.25 mm) and PD reductions (mean Δ=1.62 mm) than the PlakOut group, differences were not statistically significant due to the low number of cases.Following both initial therapy approaches, there were marked clinical improvements at four weeks from baseline. Additional subgingival application of Chlosite is safe and provided more favorable CAL gain and PD reduction than PlakOut.

Schlagwörter: Non-surgical, periodontal therapy, chlorhexidine

Konferenz/Veranstaltung:
Joint Meeting of the Continental European Division (CED),Scandinavian Division (NOF) and Israeli Division (ID) of IADR25-28 August 2004Istanbul, Turkey

High aesthetics with almost invisible scares is becoming a need in the maxillofacial area especially by extra oral incisions.In a prospective study with 14 patients we compared the aesthetic results after wound closure using 2 octyl-cyanoacrilate and conventional suture using Vicryl.In case of an unavoidable submandibular incision for example by neck dissections or salivary gland extirpations, 10 times a unilateral incision was performed and 4 times a bilateral one.As described in the study proceedings, the skin after subcutaneous suture was, either closed with skin glue or with conventional suture. The post operative results where evaluated using the Freiburger scare score after 1 week, 3 weeks, and one month.This evaluation considered: puncture sites, scare thickness, scare level, scare color and distinctive scare features.Also patient sensations and user satisfaction where evaluated.For every criteria where ad maximum 10 points given.The handling of the applicator was rated as good by the surgeons.The acceptance of the skin glue was assessed with an average of 8, 5 points by the users.The patients acceptance was assessed with 8, 9 points which was higher than by conventional suture (7, 8 points).The necessary time needed was 223 seconds using conventional skin suture, and 52 seconds using skin glue.This means a time saving of almost 76, 6%. Using the skin glue better aesthetic results where achieved.Comparing 2-octyl-cyanoacrilate with conventional suture the scare score was higher for 13 patients out of 14 in the first week, for 10 after 3 weeks and 12 after 3 months.The advantage of the skin closure using skin glue is it's simple use and the time savings. The patients acceptance to the skin glue was higher because the removal of the suture was not necessary. As an important factor for the good cosmetic results the good wound adaptation is needed.As a consequence, the use of skin glue is a very good alternative choice to conventional suture.